sufficient number of abortions, their transition to low fertility will be critically retarded. On the other hand, unless policymakers sanction abortion law reform, criminal abortionsóprovoked by amateurs under dangerous conditionsówill mount and foster an extremely serious public health problem. A deluge of complicated cases will continue to overburden the already inadequate and insufficient medical services that are needed for so many other purposes.
The problem in posttransitional countries that still have restrictive laws is twofold. There is a serious problem of illegal or criminal abortion with all the consequent social, psychological, and racketeering abuses. There is also the problem of inconsistent implementation of ambiguous and outdated laws, very often favoring the wealthy and not the poor who most need relief.
Finally, in posttransitional countries with liberalized laws, abortion prevalence persists despite the fact that contraceptives are widely available.
In all three categories of countries, therefore, policymakers should give immediate recognition to the problem of induced abortion and should plan to phase it out rather than pretend it does not exist.
2. Whereas the primary goal of every fertility regulation program is the prevention of pregnancy through effective contraception, policymakers should recognize that contraceptive failures do occur. In such cases, legal abortion is the only rational alternative to the birth of an unwanted child. Policies providing abortion services are needed to ensure that the procedure is performed safely, inexpensively, and without discrimination.
3. Countries which have already liberalized their abortion laws and those which will do so in the future should be warned against overreliance on abortion to solve fertility problems. Abortion should be but one option in the pursuit of fertility control.
4. In all cases, intensive education-guidance programs must be established. These programs are necessary to aid a smooth transition from abortion-mindedness to the achievement of balanced national and community family planning programs.
5. Both field and clinical research is needed to provide policymakers with accurate, up-to-date information about the dynamics of abortion. This is an area that should receive higher priority than ever before. Basic and applied research is needed in many areas, of which the following is only a partial list:
(a) Research in the epidemiology of abortion. Intensive and extensive research is needed to characterize the problem of abortion and its determinants in various cultures. Of particular significance is how developing countries can accomplish their demographic transition without precipitating an epidemic wave of abortion.
(b) Contraceptive research. There is great need to continue and expand basic research to increase the effectiveness of existing contraceptives, to reduce their side effects, and to develop new methods which are safe, more effective, easily administered, socially and aesthetically acceptable, and,